Herbal medicines and pharmacy

In addition to orthodox Western medicine, a plethora of complementary therapies are available in the UK and these have been steadily gaining in popularity since the 1970's. The key areas in which pharmacists are becoming increasingly involved with complementary therapies are in the sale and supply of homoeopathic products, healthfoods and nutritional supplements, and herbal products. The growing involvement of pharmacists in the supply of herbal medicines is paralleled by a requirement to provide professional advice on the use of these products. As with all medicines, pharmacists should be responsible for supplying herbal medicines of reliable quality, safety and efficacy, and be able to advise patients on such aspects as potential adverse reactions and drug interactions. If pharmacists are to be able to provide professional advice to customers on herbal medicines, then access to reliable information sources is required. However, few pharmacy undergraduate courses provide training on herbal remedies, and the usual reference sources used by pharmacists contain either no or little reference to herbal medicines. In the present work, European herbs commonly sold through pharmacies have been identified by visiting pharmacies in and around the London area, by reference to popular health magazines and to the Chemist and Druggist listing, and by contact with herbal product manufacturers. Details were obtained for 623 different products from 37 manufacturers, involving some 200 herbal ingredients of which 141 were chosen for subsequent study. The information sources utilised in the data collation for the 141 identified herbs are listed and represent pharmacopoeias, scientific and non-scientific sources, primary and secondary literature, and on-line databases. It was determined that pharmacists require clinically-orientated information on herbal remedies. Monographs produced for the 141 herbs therefore include headings such as pharmacological actions, side-effects and toxicity, and contra-indications and warnings. The present work also discusses medicines legislation for herbal remedies, including a historical account of UK legislation and an explanation of the current status of herbal remedies within European legislation. Issues specific to the quality, safety and efficacy assessment of herbal medicines are also discussed. A number of tables and appendixes are included detailing, for example, potential drug/herb interactions, herbs best avoided during pregnancy, and herbs with specific pharmacological actions and constituent types. Finally, a number of recommendations are made regarding the supply of herbal remedies by pharmacists. The present work resulted in a reference source entitled "Herbal Medicines - A Guide for Healthcare Professionals", published by the Pharmaceutical Press in January 1996